Successfully reported this slideshow.
INDIAN DENTAL ACADEMYINDIAN DENTAL ACADEMY
Leader in continuing dental educationLeader in continuing dental education
www....
PHOSPHOROUS
• Total body content-1kg-80% Bone & Teeth
• Mainly an intracellular ion (all cells)
• SOURCES:Milk(100mg/dl),c...
• Blood phoshorous:whole blood-
40mg/dl(rbcs & wbcs contain lot of
phosphate,so hemolysis shld be prevented
during Phospha...
• Functions:
• Bone & Teeth formation
• Formation of phospholipids,nucliec acids,
phosphoproteins,phosphate esters.
• Form...
• Disease state:
• Rickets:serum phosphate low
• Diabetes mellitus
• Renal Disease-retention-acidosis
• Increased levelsIn...
COPPERCOPPER
• Total body content:100-150mg
• Muscles,liver,bone
marrow,kidney,brain,heart,hair
• Daily req:2.5mg/d:2.5mg/...
• Absorption:duodenum
• Phytate,Ca,Fe,Zn,Mo decrease the absorption
• Functions:
• Haemoglobin synthesis
• Melanin formati...
•EnzymesEnzymes-ceruloplasmin,cytochrome
oxidase,cytochrome c,tyrosinase,ALA
synthetase,superoxide dismutase
•Copper conta...
• Deficiency:
• Essential for hemoglobin formation-anemiaanemia
• Cytochrome oxidase contains copper so def-
oxygen starva...
•Toxicity:
•Diarrhoea
•blue-green discolouration of saliva
•hemolysis
•hemoglobinuria
•proteinuria
•renal failure
www.indi...
Wilson’s disease/hepatolenticular degeneration:
• Rare hereditaryhereditary disease-chromosome 13 defect
• Absorption of c...
•Dysfunction of lenticular region in brain-necrosis &
sclerosis of the corpus-basal ganglion syndromesbasal ganglion syndr...
MENKE’S DISEASE:
• X-LINKED RECESSICVE DISORDER of
intestinal copper absorption.
• Absorption &transport of copper at the ...
www.indiandentalacademy.com
IRON – IN THE HUMAN
BODY
• Essential trace element.
• Total body iron content in a normal adult of 70 kg is just 3
to 5 gm...
Iron containing proteins
Name No. of iron atoms Site
Heme containing proteins
Hemoglobin 4 RBC
Myoglobin 1 Muscle
Cytochro...
Iron – Sulphur Complexes
Adrenodoxin 2 Adr. Mitochondria
Complex III Fe-S 2 Mitochondria
Succinate DH 4 Mitochondria
Xanth...
Requirement of Iron
• Daily allowance for iron, for an adult Indian is 20 mg, out
of which about 1 – 2 mg is absorbed.
• I...
Sources of Iron
• Leafy vegetables (20 mg/100g)
• Pulses (10 mg/100g)
• Cereals (5 mg/100g)
• Liver (5 mg/100g)
• Meat (2 ...
Physiological Functions
• Iron functions mainly in the transport of oxygen to the
tissues (hemoglobin).
• It is also invol...
Regulation of Absorption of Iron
• Duodenum and jejunum are the sites of
absorption.
• Iron metabolism is unique because h...
Intestinal lumen
Intestinal cell
Blood stream
www.indiandentalacademy.com
Intestinal lumen
Intestinal cell
Blood stream
www.indiandentalacademy.com
• Iron in the intestinal lumen enters the mucosal cell in the
ferrous state.
• This is bound to transferrin molecule prese...
Iron Transport in Blood
• Transport form of iron is transferrin.
• It is a glycoprotein synthesized by liver cells.
• Norm...
Storage of Iron
• Iron is stored in liver, spleen and bone marrow.
• The storage form of iron is ferritin.
• It is seen in...
Iron is Conserved
RBC lysis
Hb Hb – Haptoglobin complex taken
up by liver Kupffer’s cells Iron re-utilized
Globin removed
...
Excretion of Iron
• Iron is a one-way element. That is, very little of it is
excreted.
• The regulation of homeostasis is ...
• Anemia results when this delicate balance is upset in one
of the three main ways.
1. Increased output
Chronic blood loss...
Iron Deficiency Anemia
• It is the most common nutritional deficiencynutritional deficiency diseases.
• About 30% of world...
Causes
• Hookworm infection
• Nutritional deficiency of iron
• Repeated pregnancy
• Chronic blood loss, e.g. bleeding hemo...
• Red cell count 3 -4 million/cu.mm.
• Red cells become microcytic, hypochromic.
• Anisocytosis and poikilocytosis of RBCs...
Clinical Features
• Anemia results when Hb level is less than 12 g/dlless than 12 g/dl.
• When the level is lower than 10 ...
• Similar atrophy of the
epithelium in the oral
cavity and oesophagus
causes dysphagiadysphagia called
Plummer-WilsonPlumm...
• Koilonychia (spoon
shaped fingernails).
• Very chronic iron
deficiency anemia will
lead to impaired attentionimpaired at...
Treatment
• Oral iron supplementationOral iron supplementation is the treatment of choice.
• The National Nutritional Anem...
FLUORIDES
www.indiandentalacademy.com
0.05 – 1.89 mg/m³
Industrial exhaust
Volcanic activity
Suspended soil particles
0.06% - 0.09%
Flourspar CaF2
Flourapaptite...
Sources of fluoride
• Total daily intake is in the range of 1.7 – 3.3 mg1.7 – 3.3 mg
for adults.
• Intake of 0.05 – 0.07 m...
Gastrointestinal system
Rapid and almost complete absorptionRapid and almost complete absorption.
Passive absorption.
Solu...
Plasma
Maximum concentration occurs in 30 – 60 minutesMaximum concentration occurs in 30 – 60 minutes.
Levels start decrea...
99% of F in human body is found in calcified tissues.
Metabolically active bone parts take up more fluoride.
After the per...
Enamel
Highest on enamel surface compared to interior.
Dentin
Highest concentration at pulpal surface.
www.indiandentalaca...
Excretion
Chief organ of excretion is the kidney.
High urinary flow and an alkaline urine helps in clearance.
Small amount...
FUNCTIONS
• Teeth development
• With vitaminD in tretment of osteoporosis
• Sodium f;ouride is a powerful inb of glycolyti...
Acute toxicity
GIT: nausea,vomiting,abdominal cramps.
Neurological:paresthesia,CNS depression.
CVS:Hypotension,shock,arryt...
0.7-1.2ppm Lifelong
Prevents dental
caries
1.5-3ppm
5-10 years or
more
Milder forms of
dental fluorosis
3-8ppm
15-20years ...
Dean's Classification Criteria for Dental Fluorosis:
"Very Mild" - "Small opaque, paper white areas scattered irregularly ...
"Moderate" - "All enamel surfaces of the teeth are affected, and the surfaces
subject to attrition show wear. Brown stain ...
Chronic toxicity:skeletal fluorosis
Osteosclerosis and osteoporosis occurs.
Thickening of cortical bone and
calcification ...
Thank you
www.indiandentalacademy.com
For more details please visit
www.indiandentalacademy.com
Upcoming SlideShare
Loading in …5
×

Phosphorus /certified fixed orthodontic courses by Indian dental academy

731 views

Published on


The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

Published in: Health & Medicine, Sports
  • Be the first to comment

  • Be the first to like this

Phosphorus /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMYINDIAN DENTAL ACADEMY Leader in continuing dental educationLeader in continuing dental education www.indiandentalacademy.comwww.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. PHOSPHOROUS • Total body content-1kg-80% Bone & Teeth • Mainly an intracellular ion (all cells) • SOURCES:Milk(100mg/dl),cheese,egg yolk,meat,fish,cereals,nuts • Daily requirement:800mg/D • Distribution:Serum(inorg):3-4.5mg/100ml • Bone & teeth:22,000mg/100mg www.indiandentalacademy.com
  3. 3. • Blood phoshorous:whole blood- 40mg/dl(rbcs & wbcs contain lot of phosphate,so hemolysis shld be prevented during Phosphate estimation of blood) • Act as a BUFFER • Forms:inorg,org,phospholipids. • Excretion:through urine:500mg/D • Reabsorption inb by parathyroid hormone • Serum phosphate decreased in hyperparathyroidism & rickets. www.indiandentalacademy.com
  4. 4. • Functions: • Bone & Teeth formation • Formation of phospholipids,nucliec acids, phosphoproteins,phosphate esters. • Formation of organic phosphates • Formation of ATP • Synthesis of NADP,NAD,ADP,AMP • Activation of enzymes by phosphorylation • Buffer www.indiandentalacademy.com
  5. 5. • Disease state: • Rickets:serum phosphate low • Diabetes mellitus • Renal Disease-retention-acidosis • Increased levelsIncreased levels: • hypoparathyroidism,renal rickets(familial hypophosphatemia,vitamin D resistant rickets) • DecreaseDecrease: • hyperparathyroidism,celiac d,vitamin D def. www.indiandentalacademy.com
  6. 6. COPPERCOPPER • Total body content:100-150mg • Muscles,liver,bone marrow,kidney,brain,heart,hair • Daily req:2.5mg/d:2.5mg/d • Sources:liver,kidney,meat:liver,kidney,meat,shell fish,nuts,legumes,green leafy vegtables • Blood copper:90mcg/100ml • Rbcs-erythrocuprein • Serum-ceruloplasmin[firmly bound]&loosely bound to albumin.www.indiandentalacademy.com
  7. 7. • Absorption:duodenum • Phytate,Ca,Fe,Zn,Mo decrease the absorption • Functions: • Haemoglobin synthesis • Melanin formation • Phosholipid & collagen synthesis • Bone formation • Myelin sheath integrity www.indiandentalacademy.com
  8. 8. •EnzymesEnzymes-ceruloplasmin,cytochrome oxidase,cytochrome c,tyrosinase,ALA synthetase,superoxide dismutase •Copper containing proteinsCopper containing proteins- hepatocuprein,cuprothionine,cerebrocuprein,hemo cuprein •CeruloplasminCeruloplasmin:serum ferroxidase:during Fe transport promotes oxidation of ferrous ion to ferric form which is incorporated into transferrin •Superoxide dismutaseSuperoxide dismutase:enzyme which scavenges toxic free radical superoxide ion formed during aerobic metabolism www.indiandentalacademy.com
  9. 9. • Deficiency: • Essential for hemoglobin formation-anemiaanemia • Cytochrome oxidase contains copper so def- oxygen starvation-neonatal ataxiaoxygen starvation-neonatal ataxia • Connective tissue metabolism-lysyl oxidase-crosslysyl oxidase-cross linkage of elastin & collagenlinkage of elastin & collagen-so deficiency- weakening of vessel walls-aneurysm,rupture.also minkes kinky hair syndromeminkes kinky hair syndrome. • Present in Tyrosinase-melanin formationTyrosinase-melanin formation- hypopigmentation,grey hair,flag type of hair growth. • Marked skl changes-osteoporosisosteoporosis & spontaneousspontaneous fracturesfractures www.indiandentalacademy.com
  10. 10. •Toxicity: •Diarrhoea •blue-green discolouration of saliva •hemolysis •hemoglobinuria •proteinuria •renal failure www.indiandentalacademy.com
  11. 11. Wilson’s disease/hepatolenticular degeneration: • Rare hereditaryhereditary disease-chromosome 13 defect • Absorption of copperAbsorption of copper from intestine very highhigh,ceruloplasmin formation very less,majority of the serum copper remains loosely bound to serum protein,albumin,so is transported to tissues like brain & liverbrain & liver • Clinical features: • Progressive hepatic cirrhosishepatic cirrhosis-Portal HT,HF www.indiandentalacademy.com
  12. 12. •Dysfunction of lenticular region in brain-necrosis & sclerosis of the corpus-basal ganglion syndromesbasal ganglion syndromes •Damage to renal tubulesrenal tubules •Copper deposits in descement’s membrane of the eye-golden brown or yellow or green ring around the cornea-KAYSER FLEISCHER RING •PIGMENTATION OF NAILS, SKIN •TREATEMENT:TREATEMENT: •PENNICILLAMINE www.indiandentalacademy.com
  13. 13. MENKE’S DISEASE: • X-LINKED RECESSICVE DISORDER of intestinal copper absorption. • Absorption &transport of copper at the serosal aspect is defective. • C/f: • Mental retardation,temperature instability,abnormal bone formation,susceptibility to infection. www.indiandentalacademy.com
  14. 14. www.indiandentalacademy.com
  15. 15. IRON – IN THE HUMAN BODY • Essential trace element. • Total body iron content in a normal adult of 70 kg is just 3 to 5 gms. • 75% of this is in blood, the rest is in liver, bone marrow and muscles. • Iron is present in almost all cells. www.indiandentalacademy.com
  16. 16. Iron containing proteins Name No. of iron atoms Site Heme containing proteins Hemoglobin 4 RBC Myoglobin 1 Muscle Cytochrome oxidase 2 Mitochondria Cytochrome b 1 Mitochondria Cytochrome c1 1 Mitochondria Cytochrome c 1 Mitochondria Cytochrome b5 1 ER Cytochrome p-450 1 ER, Mitochondria Catalase 4 RBC Lactoperoxidase 1 Milk Tryptophan pyrrolase 4 Cytosol www.indiandentalacademy.com
  17. 17. Iron – Sulphur Complexes Adrenodoxin 2 Adr. Mitochondria Complex III Fe-S 2 Mitochondria Succinate DH 4 Mitochondria Xanthine oxidase 8 Liver Non – Heme Containing Proteins Aconitase 2 TCA cycle Phe-hydoxylase 2 Liver Transferrin 2 Plasma Lactoferrin 2 Milk Ferritin 4,000 Tissues Hemosiderin many Liverwww.indiandentalacademy.com
  18. 18. Requirement of Iron • Daily allowance for iron, for an adult Indian is 20 mg, out of which about 1 – 2 mg is absorbed. • In western countries, requirement is 15 mg/day because the diet does not contain inhibitory substances. • Children between 13 – 15 years need 20 – 30 mg/day. • Pregnant women need 40 mg/day. • Transfer of iron and calcium from mother to fetus occurs mainly in the last trimester of pregnancy. www.indiandentalacademy.com
  19. 19. Sources of Iron • Leafy vegetables (20 mg/100g) • Pulses (10 mg/100g) • Cereals (5 mg/100g) • Liver (5 mg/100g) • Meat (2 mg/100g) • Jaggery, heart, kidney, spleen, egg-yolk, fish, nuts, figs, dates, beans, molasses, apples, bananas etc. • Milk is a very poor source of iron (0.1 mg/100 ml) • Human milk contains 0.3 to 0.6 µg iron/ml. • In a typical Indian diet, the major quantity of iron is received from cereals because of the bulk quantity taken, although they contain iron only in moderate amounts. • Cooking in iron utensils. www.indiandentalacademy.com
  20. 20. Physiological Functions • Iron functions mainly in the transport of oxygen to the tissues (hemoglobin). • It is also involved in the processes of cellular respiration. • It is an essential component of hemoglobin, myoglobin, cytochromes and the respiratory enzyme systems. • The non-heme iron is completely protein-bound which exists in the form of storage and transport. • The non-heme iron is also utilized in the structure of the xanthine dehydrogenase and the succinate dehydrogenase and also in the iron and sulphur proteins of the respiratory chain. www.indiandentalacademy.com
  21. 21. Regulation of Absorption of Iron • Duodenum and jejunum are the sites of absorption. • Iron metabolism is unique because homeostasis is maintained by regulation at the level of absorption and NOT by excretion. – When iron stores in the body are depleted, absorption is enhanced. When adequate quantity of iron is stored, absorption is decreased. This is referred to as ‘mucosal block’ of regulation of absorption of iron. www.indiandentalacademy.com
  22. 22. Intestinal lumen Intestinal cell Blood stream www.indiandentalacademy.com
  23. 23. Intestinal lumen Intestinal cell Blood stream www.indiandentalacademy.com
  24. 24. • Iron in the intestinal lumen enters the mucosal cell in the ferrous state. • This is bound to transferrin molecule present in brush border surface of intestinal cell. • One transferrin molecule can bind with two atoms of iron. • This is then complexed with a specific receptor. • This iron-transferrin-receptor is internalised. • Iron is taken in by the cells, and receptor molecules are externalised; this cycle is completed within 30 seconds. • This receptor mediated uptake is more in iron-deficient state. When iron is in excess, receptors are not produced. • This is the basis of ‘mucosal block’.www.indiandentalacademy.com
  25. 25. Iron Transport in Blood • Transport form of iron is transferrin. • It is a glycoprotein synthesized by liver cells. • Normal plasma level of transferrin is 250 mg/100 ml. • In iron deficiency, this level is increased. • Total iron binding capacity (TIBC) in plasma is 400 µg/100 ml; this is provided by the transferrin. • Normally one-third of this capacity is saturated with iron. This protein bound iron (serum iron) is about 120 µg/100 ml. • In iron deficiency anemia, TIBC is increased (transferrin level increased); but serum iron level is reduced. www.indiandentalacademy.com
  26. 26. Storage of Iron • Iron is stored in liver, spleen and bone marrow. • The storage form of iron is ferritin. • It is seen in intestinal mucosal cells, liver, spleen and bone marrow. • The apo-ferritin can take upto 4,000 iron atoms per molecule to become ferritin. • In iron deficiency anemia, ferritin content is reduced. When iron is given in anemia, the apo- ferritin production is induced within a few hours. www.indiandentalacademy.com
  27. 27. Iron is Conserved RBC lysis Hb Hb – Haptoglobin complex taken up by liver Kupffer’s cells Iron re-utilized Globin removed Heme Heme-Hemopexin complex taken by hepatocytes Porphyrin removed Bilirubin Iron Iron-Transferrin Storage Iron re-utilized Iron re-utilizedwww.indiandentalacademy.com
  28. 28. Excretion of Iron • Iron is a one-way element. That is, very little of it is excreted. • The regulation of homeostasis is done at the absorption level. • Any type of bleeding will cause loss of iron from the body. • Menstrual flow is the major cause for loss of iron in women. Women upto menopause will lose iron at a rate of about 1 mg/day. • The loss in male is less than 0.5 mg/day. www.indiandentalacademy.com
  29. 29. • Anemia results when this delicate balance is upset in one of the three main ways. 1. Increased output Chronic blood loss In females – uterine bleeding In both sexes – bleeding from alimentary tract. 1. Decreased input Poor diet Malabsorption 1. Increased body requirement During rapid growth in child In pregnancy www.indiandentalacademy.com
  30. 30. Iron Deficiency Anemia • It is the most common nutritional deficiencynutritional deficiency diseases. • About 30% of world population are anemic. All over India, this is about 70%.70%. • Prevalence rate of anemia is lowest (33%) in Andhra Pradesh and highest (90%) in Rajasthan. • 85% of pregnant women suffer from anemia. • 15% of all maternal deathsmaternal deaths are attributed to anemia. • Maternal anemia contributes to increase in perinatalperinatal mortality.mortality. • The usual Indian diet contains inhibitors of absorptionIndian diet contains inhibitors of absorption. Hence Indians are more prone to develop iron deficiency anemia. www.indiandentalacademy.com
  31. 31. Causes • Hookworm infection • Nutritional deficiency of iron • Repeated pregnancy • Chronic blood loss, e.g. bleeding hemorrhoids, peptic ulcer, uterine hemorrhage. • Nephrosis • Lack of absorption, e.g. subtotal gastrectomy and achlorhydria. • In lead toxicity www.indiandentalacademy.com
  32. 32. • Red cell count 3 -4 million/cu.mm. • Red cells become microcytic, hypochromic. • Anisocytosis and poikilocytosis of RBCs. Fairly uniform red cells – size and shape (mean diameter 7.2 µ) Definite central pallor – ring staining Variation in size – anisocytosis Variation in shape - poikilocytosis Laboratory findings www.indiandentalacademy.com
  33. 33. Clinical Features • Anemia results when Hb level is less than 12 g/dlless than 12 g/dl. • When the level is lower than 10 g/dl body cells lackbody cells lack oxygenoxygen and the patient becomes uninterested in surroundings (apathy(apathy). • Since iron is an important constituent of cytochromes, their deficiency leads to derangement in internal respiration and all metabolic processes become sluggishmetabolic processes become sluggish. www.indiandentalacademy.com
  34. 34. • Similar atrophy of the epithelium in the oral cavity and oesophagus causes dysphagiadysphagia called Plummer-WilsonPlummer-Wilson syndromesyndrome which is a known pre-cancerouspre-cancerous condition.condition. • Cracks or fissures at the corner of the mouth, and a smooth, red painfulsmooth, red painful tonguetongue with atrophy of filiform papillae and later fungiform papillae. www.indiandentalacademy.com
  35. 35. • Koilonychia (spoon shaped fingernails). • Very chronic iron deficiency anemia will lead to impaired attentionimpaired attention, irritability, lower memoryirritability, lower memory and poor scholastic performance. www.indiandentalacademy.com
  36. 36. Treatment • Oral iron supplementationOral iron supplementation is the treatment of choice. • The National Nutritional Anemia Prophylaxis Programme was initiated in India in 1970. – 100 mg of iron + 500 µg of folic acid for pregnant women. – 20 mg of iron + 100 µg of folic acid to children. www.indiandentalacademy.com
  37. 37. FLUORIDES www.indiandentalacademy.com
  38. 38. 0.05 – 1.89 mg/m³ Industrial exhaust Volcanic activity Suspended soil particles 0.06% - 0.09% Flourspar CaF2 Flourapaptite Ca10Po4O6F2 Cryolite Na3AlF6 Volcanic rocks Salt deposits of marine origin Lakes, wells, river water 0.5 – 1.4 mg/kg Sea water 0.8 – 1.4 mg/kg www.indiandentalacademy.com
  39. 39. Sources of fluoride • Total daily intake is in the range of 1.7 – 3.3 mg1.7 – 3.3 mg for adults. • Intake of 0.05 – 0.07 mg/kg body weight0.05 – 0.07 mg/kg body weight is considered optimum. • 1.5 mg comes from water. • 0.2 – 1.8 mg comes from dry food. • Rich sources are: fish, banana, potatoes, jowar, teatea leaves.leaves. • Fluoride concentration in human milk ranges from 6 – 12 mg/ml. • Whether fluoride crosses placental barrier is debatable. www.indiandentalacademy.com
  40. 40. Gastrointestinal system Rapid and almost complete absorptionRapid and almost complete absorption. Passive absorption. Soluble fluorides (sodium salts) completely absorbed. 100% on empty stomach 75% with a glass of milk 60% with calcium rich breakfast Fluoride is absorbed as HFFluoride is absorbed as HF Absorption increased in alkaline mediumAbsorption increased in alkaline medium Remaining absorption occurs in small intestine 3 mg F as NaF www.indiandentalacademy.com
  41. 41. Plasma Maximum concentration occurs in 30 – 60 minutesMaximum concentration occurs in 30 – 60 minutes. Levels start decreasing after 2 hours. Normal levels achieved in 24 hours which is 4microgram100ml4microgram100ml Half life is 2 – 9 hours depending upon subject. F occurs in both ionic and bound formsF occurs in both ionic and bound forms. Ionic portion levels vary according to F content of water. www.indiandentalacademy.com
  42. 42. 99% of F in human body is found in calcified tissues. Metabolically active bone parts take up more fluoride. After the period of growth ends the F concentration continues to rise more slowly than before and tend to reach a constant level. Bones www.indiandentalacademy.com
  43. 43. Enamel Highest on enamel surface compared to interior. Dentin Highest concentration at pulpal surface. www.indiandentalacademy.com
  44. 44. Excretion Chief organ of excretion is the kidney. High urinary flow and an alkaline urine helps in clearance. Small amounts are also excreted via faeces and sweat. www.indiandentalacademy.com
  45. 45. FUNCTIONS • Teeth development • With vitaminD in tretment of osteoporosis • Sodium f;ouride is a powerful inb of glycolytic enzyme enolase • Resistance to dental caries • Citric acid cycle-inb of aconitase activity,responsible for conversion of citrate to cis-aconitase www.indiandentalacademy.com
  46. 46. Acute toxicity GIT: nausea,vomiting,abdominal cramps. Neurological:paresthesia,CNS depression. CVS:Hypotension,shock,arrythmia. Certainly lethal dose:32-64mg/kg Safely tolerated dose:8-16mg/kg Minimum lethal dose has not been established. www.indiandentalacademy.com
  47. 47. 0.7-1.2ppm Lifelong Prevents dental caries 1.5-3ppm 5-10 years or more Milder forms of dental fluorosis 3-8ppm 15-20years or more Severe form of dental fluorosis and milder form of skeletal fluorosis >8ppm 5-10years or more Severe dental and skeletal fluorosis. Fluoride levels Time Effects Chronic toxicity www.indiandentalacademy.com
  48. 48. Dean's Classification Criteria for Dental Fluorosis: "Very Mild" - "Small opaque, paper white areas scattered irregularly over the tooth but not involving as much as 25 percent of the tooth surface." (Dean 1942) "Mild" - "The white opaque areas in the enamel of the teeth are more extensive but do not involve as much as 50 percent of the tooth." (Dean 1942) Very Mild/Mild Fluorosis Mild Fluorosis Chronic toxicity:dental fluorosis www.indiandentalacademy.com
  49. 49. "Moderate" - "All enamel surfaces of the teeth are affected, and the surfaces subject to attrition show wear. Brown stain is frequently a disfiguring feature.” (Dean 1942) “Severe" - "All enamel surfaces are affected and hypoplasia is so marked that the general form of the tooth may be affected. The major diagnostic sign of this classification is discrete or confluent pitting. Brown stains are widespread and teeth often present a corroded-like appearance.” (Dean 1942) Severe FluorosisModerate Fluorosis www.indiandentalacademy.com
  50. 50. Chronic toxicity:skeletal fluorosis Osteosclerosis and osteoporosis occurs. Thickening of cortical bone and calcification of ligaments and tendons. Severe pain and stiffness in joints and spine.Deformities of upper and lower limbs. Crippling fluorosis is the most severe form in which spine becomes rigid and joints stiffen. www.indiandentalacademy.com
  51. 51. Thank you www.indiandentalacademy.com For more details please visit www.indiandentalacademy.com

×